Skip to main content

Advertisement

SpringerLink
Log in

Phase angle assessment by bioelectrical impedance analysis and its predictive value for malnutrition risk in hospitalized geriatric patients

  • Original Article
  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

Abstract

Background

Phase angle (PhA) value determined by bioelectrical impedance analysis (BIA) is an indicator of cell membrane damage and body cell mass. Recent studies have shown that low PhA value is associated with increased nutritional risk in various group of patients. However, there have been only a few studies performed globally assessing the relationship between nutritional risk and PhA in hospitalized geriatric patients. The aim of the study is to evaluate the predictive value of the PhA for malnutrition risk in hospitalized geriatric patients.

Methods

One hundred and twenty-two hospitalized geriatric patients were included in this cross-sectional study. Comprehensive geriatric assessment tests and BIA measurements were performed within the first 48 h after admission. Nutritional risk state of the patients was determined with NRS-2002. Phase angle values of the patients with malnutrition risk were compared with the patients that did not have the same risk. The independent variables for predicting malnutrition risk were determined. SPSS version 15 was utilized for the statistical analyzes.

Results

The patients with malnutrition risk had significantly lower phase angle values than the patients without malnutrition risk (p = 0.003). ROC curve analysis suggested that the optimum PhA cut-off point for malnutrition risk was 4.7° with 79.6 % sensitivity, 64.6 % specificity, 73.9 % positive predictive value, and 73.9 % negative predictive value. BMI, prealbumin, PhA, and Mini Mental State Examination Test scores were the independent variables for predicting malnutrition risk.

Conclusions

PhA can be a useful, independent indicator for predicting malnutrition risk in hospitalized geriatric patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Agarwal E, Ferguson M, Banks M et al (2013) Malnutrition and poor food intake are associated with prolonged hospital stay, frequent readmissions, and greater in-hospital mortality: results from the Nutrition Care Day Survey 2010. Clin nutrition 32:737–745

    Article  Google Scholar 

  2. Felblinger DM (2003) Malnutrition, infection, and sepsis in acute and chronic illness. Crit Care Nurs Clin North Am 15:71–78

    Article  PubMed  Google Scholar 

  3. Seiler WO (2001) Clinical pictures of malnutrition in ill elderly subjects. Nutrition 17:496–498

    Article  CAS  PubMed  Google Scholar 

  4. Kuyumcu M, Yesil Y, Oztürk ZA et al (2013) Challenges in nutritional evaluation of hospitalized elderly; always with mini-nutritional assessment? Eur Geriatr Med 4:231–236

    Article  Google Scholar 

  5. Kondrup J, Rasmussen HH, Hamberg O et al (2003) Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr 22:321–336

    Article  PubMed  Google Scholar 

  6. Maggiore Q, Nigrelli S, Ciccarelli C et al (1996) Nutritional and prognostic correlates of bioimpedance indexes in hemodialysis patients. Kidney Int 50:2103–2108

    Article  CAS  PubMed  Google Scholar 

  7. Nagano M, Suita S, Yamanouchi T (2000) The validity of bioelectrical impedance phase angle for nutritional assessment in children. J Pediatr Surg 35:1035–1039

    Article  CAS  PubMed  Google Scholar 

  8. Oliveira CM, Kubrusly M, Mota RS et al (2010) The phase angle and mass body cell as markers of nutritional status in hemodialysis patients. J Renal Nutr Off J Counc Renal Nutr Natl Kidney Found 20:314–320

    Article  Google Scholar 

  9. Mushnick R, Fein PA, Mittman N et al (2003) Relationship of bioelectrical impedance parameters to nutrition and survival in peritoneal dialysis patients. Kidney Int Suppl 87:S53–S56

    Article  Google Scholar 

  10. Gupta D, Lammersfeld CA, Burrows JL et al (2004) Bioelectrical impedance phase angle in clinical practice: implications for prognosis in advanced colorectal cancer. Am J Clin Nutr 80:1634–1638

    CAS  PubMed  Google Scholar 

  11. Barbosa-Silva MC, Barros AJ (2005) Bioelectric impedance and individual characteristics as prognostic factors for post-operative complications. Clin Nutr 24:830–838

    Article  PubMed  Google Scholar 

  12. Katz S, Ford AB, Moskowitz RW et al (1963) Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA 185:914–919

    Article  CAS  PubMed  Google Scholar 

  13. Katz S, Downs TD, Cash HR et al (1970) Progress in development of the index of ADL. Gerontologist 10:20–30

    Article  CAS  PubMed  Google Scholar 

  14. Graf C (2009) The Lawton Instrumental Activities of Daily Living (IADL) Scale. Medsurg Nurs Off J Acad Med Surg Nurs 18:315–316

    Google Scholar 

  15. Yesavage JA (1988) Geriatric Depression Scale. Psychopharmacol Bull 24:709–711

    CAS  PubMed  Google Scholar 

  16. Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198

    Article  CAS  PubMed  Google Scholar 

  17. Tinetti ME (1986) Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc 34:119–126

    Article  CAS  PubMed  Google Scholar 

  18. Baumgartner RN, Chumlea WC, Roche AF (1988) Bioelectric impedance phase angle and body composition. Am J Clin Nutr 48:16–23

    CAS  PubMed  Google Scholar 

  19. Selberg O, Selberg D (2002) Norms and correlates of bioimpedance phase angle in healthy human subjects, hospitalized patients, and patients with liver cirrhosis. Eur J Appl Physiol 86:509–516

    Article  CAS  PubMed  Google Scholar 

  20. De Luis DA, Izaola O, Aller R (2007) Nutritional status in head and neck cancer patients. Eur Rev Med Pharmacol Sci 11:239–243

    PubMed  Google Scholar 

  21. Gupta D, Lis CG, Dahlk SL et al (2004) Bioelectrical impedance phase angle as a prognostic indicator in advanced pancreatic cancer. Br J Nutr 92:957–962

    Article  CAS  PubMed  Google Scholar 

  22. Gupta D, Lammersfeld CA, Vashi PG et al (2008) Bioelectrical impedance phase angle as a prognostic indicator in breast cancer. BMC Cancer 8:249

    Article  PubMed  PubMed Central  Google Scholar 

  23. Gupta D, Lammersfeld CA, Vashi PG et al (2009) Bioelectrical impedance phase angle in clinical practice: implications for prognosis in stage IIIB and IV non-small cell lung cancer. BMC Cancer 9:37

    Article  PubMed  PubMed Central  Google Scholar 

  24. Kyle UG, Genton L, Pichard C (2013) Low phase angle determined by bioelectrical impedance analysis is associated with malnutrition and nutritional risk at hospital admission. Clin Nutr 32:294–299

    Article  PubMed  Google Scholar 

  25. Norman K, Smoliner C, Valentini L et al (2007) Is bioelectrical impedance vector analysis of value in the elderly with malnutrition and impaired functionality? Nutrition 23:564–569

    Article  PubMed  Google Scholar 

  26. Slee A, Birc D, Stokoe D (2015) Bioelectrical impedance vector analysis, phase-angle assessment and relationship with malnutrition risk in a cohort of frail older hospital patients in the United Kingdom. Nutrition 31:132–137

    Article  PubMed  Google Scholar 

  27. Guida B, Laccetti R, Gerardi C et al (2007) Bioelectrical impedance analysis and age-related differences of body composition in the elderly. Nutr Metab Cardiovasc Dis NMCD 17:175–180

    Article  PubMed  Google Scholar 

  28. Barbosa-Silva MC, Barros AJ, Wang J et al (2005) Bioelectrical impedance analysis: population reference values for phase angle by age and sex. Am J Clin Nutr 82:49–52

    CAS  PubMed  Google Scholar 

  29. Drescher T, Singler K, Ulrich A et al (2010) Comparison of two malnutrition risk screening methods (MNA and NRS 2002) and their association with markers of protein malnutrition in geriatric hospitalized patients. Eur J Clin Nutr 64:887–893

    Article  CAS  PubMed  Google Scholar 

  30. Farias CL, Campos DJ, Bonfin CM et al (2013) Phase angle from BIA as a prognostic and nutritional status tool for children and adolescents undergoing hematopoietic stem cell transplantation. Clin Nutr 32:420–425

    Article  PubMed  Google Scholar 

  31. Wilhelm-Leen ER, Hall YN, Horwitz RI et al (2014) Phase angle, frailty and mortality in older adults. J Gen Intern Med 29:147–154

    Article  PubMed  Google Scholar 

  32. Norman K, Wirth R, Neubauer M et al (2015) The bioimpedance phase angle predicts low muscle strength, impaired quality of life, and increased mortality in old patients with cancer. J Am Med Dir Assoc 16:173.e117–173.e122

    Article  Google Scholar 

  33. Wirth R, Volkert D, Rosler A et al (2010) Bioelectric impedance phase angle is associated with hospital mortality of geriatric patients. Arch Gerontol Geriatr 51:290–294

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

There are no sources of support including sponsorship or no source of material that is available commercially.

Author information

Authors and Affiliations

  1. Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, 06100, Ankara, Turkey

    Hacer Dogan Varan, Ozgur Kara, Gunes Arik, Muhammet Cemal Kizilarslanoglu, Mustafa Kemal Kilic, Fatih Sumer, Mehmet Emin Kuyumcu, Yusuf Yesil, Burcu Balam Yavuz, Meltem Halil & Mustafa Cankurtaran

  2. Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey

    Basak Bolayir

Authors
  1. Hacer Dogan Varan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Basak Bolayir
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ozgur Kara
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gunes Arik
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Muhammet Cemal Kizilarslanoglu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mustafa Kemal Kilic
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Fatih Sumer
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mehmet Emin Kuyumcu
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yusuf Yesil
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Burcu Balam Yavuz
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Meltem Halil
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Mustafa Cankurtaran
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hacer Dogan Varan.

Ethics declarations

Conflict of interest

The authors declare no conflict of interest.

Human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all participants prior to their inclusion in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Varan, H.D., Bolayir, B., Kara, O. et al. Phase angle assessment by bioelectrical impedance analysis and its predictive value for malnutrition risk in hospitalized geriatric patients. Aging Clin Exp Res 28, 1121–1126 (2016). https://doi.org/10.1007/s40520-015-0528-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40520-015-0528-8

Keywords

Search

Navigation